BILL ANALYSIS �
AB 954
Page 1
Date of Hearing: April 16, 2013
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Mark Stone, Chair
AB 954 (Maienschein) - As Introduced: February 22, 2013
SUBJECT : Developmental Services: habilitation
SUMMARY : Increases the rates and fees paid to supported
employment services providers for regional center consumers.
Specifically, this bill :
1)Increases the hourly rate for supported employment services
provided to consumers receiving individualized or group
services to $34.24.
2)Increases the fee regional centers pay interim program
providers to complete the intake process for a consumer
entering a supported employment program to $400.
3)Increases the fee paid for placement of a consumer in an
integrated job and the fee paid after a consumer is retained
in a job for 90 days to $800 apiece.
EXISTING LAW
1)Establishes the Lanterman Developmental Disabilities Services
Act (Lanterman Act), under which the Department of
Developmental Services (DDS) is authorized to contract with
private non-profit regional centers to provide case management
services and arrange for, or purchase, services that meet the
needs of individuals with developmental disabilities, as
defined.
2)Grants all individuals with developmental disabilities, among
all other rights and responsibilities established for any
individual by the United States Constitution and laws and the
California Constitution and laws, the right to treatment and
habilitation services and supports in the least restrictive
environment.
3)Requires the development of an Individual Program Plan (IPP)
for each regional center consumer, which specifies services to
be provided to the consumer, based on an individualized needs
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determination.
4)States the Legislature's intent that habilitation services for
adults with developmental disabilities be planned and provided
in a manner that enables persons with developmental
disabilities to approximate the pattern of everyday living
available to nondisabled people of the same age.
5)Defines "habilitation services" as community-based services
purchased or provided for adults with developmental
disabilities, including services provided under the Work
Activity Program and the Supported Employment Program, to
prepare and maintain them at their highest level of vocational
functioning, or to prepare them for referral to vocational
rehabilitation services.
6)Requires a regional center to authorize appropriate
habilitation services for a consumer while he or she awaits
service authorization from the Department of Rehabilitation if
the regional center has referred that consumer to the
Department of Rehabilitation for vocational rehabilitation
services, and the consumer is put on a waiting list.
7)Establishes the following rates and fees to be paid to interim
providers of rehabilitation services that are authorized by
the regional center for the period during which a consumer is
on a waiting list for vocational services from the Department
of Rehabilitation:
a) A rate of thirty dollars and eighty-two cents ($30.82)
per hour for supported employment services provided to
consumers receiving individualized or group services;
b) A three-hundred-sixty-dollar ($360) fee to be paid to a
program provider upon intake of a consumer into a supported
employment program;
c) A seven-hundred-twenty-dollar ($720) fee to be paid upon
placement of a consumer in an integrated job, as specified;
and
d) A seven-hundred-twenty-dollar ($720) fee to be paid
after a 90-day retention of a consumer in a job, as
specified.
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FISCAL EFFECT : Unknown
BACKGROUND
The Lanterman Act (Welfare & Institutions (W&I) Code � 4500 et
seq.) guides the provision of services and supports for
Californians with developmental disabilities. Each individual
under the Act, typically referred to as a "consumer," is legally
entitled to treatment and habilitation services and supports in
the least restrictive environment. Lanterman Act services are
designed to enable all consumers to live more independent and
productive lives in the community.
The term "developmental disability" means a disability that
originates before an individual attains 18 years of age, is
expected to continue indefinitely, and constitutes a substantial
disability for that individual. It includes intellectual
disabilities, cerebral palsy, epilepsy, and autism spectrum
disorders (ASD). Other developmental disabilities are those
disabling conditions similar to an intellectual disability that
require treatment (i.e., care and management) similar to that
required by individuals with an intellectual disability. This
does not include conditions that are solely psychiatric or
physical in nature, and the conditions must occur before age 18,
result in a substantial disability, be likely to continue
indefinitely, and involve brain damage or dysfunction. Examples
of conditions might include intracranial neoplasms, degenerative
brain disease or brain damage associated with accidents.
Direct responsibility for implementation of the Lanterman Act
service system is shared by the Department of Developmental
Services (DDS) and 21 regional centers, which are private
nonprofit entities, established pursuant to the Lanterman Act,
that contract with DDS to carry out many of the state's
responsibilities under the Act. The principal roles of regional
centers include intake and assessment, individualized program
plan development, case management, and securing services through
generic agencies or purchasing services provided by vendors.
Regional centers also share primary responsibility with local
education agencies for provision of early intervention services
under the California Early Intervention Services Act.
The 21 regional centers throughout the state serve over 250,000
consumers who receive services such as residential placements,
supported living services, respite care, transportation, day
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treatment programs, work support programs, and various social
and therapeutic activities. Approximately 1,600 consumers
reside at one of California's four Developmental Centers-and one
state-operated, specialized community facility-which provide
24-hour habilitation and medical and social treatment services.
Over 125,000 regional center consumers are of working age.
Services provided to people with developmental disabilities are
determined through an individual planning process. Under this
process, planning teams-which include, among others, the
consumer, his or her legally authorized representative, and one
or more regional center representatives-jointly prepare an
Individual Program Plan (IPP) based on the consumer's needs and
choices. The Lanterman Act requires that the IPP promote
community integration and maximize opportunities for each
consumer to develop relationships, be part of community life,
increase control over his or her life, and acquire increasingly
positive roles in the community. The IPP must give the highest
preference to those services and supports that allow minors to
live with their families and adults to live as independently as
possible in the community.
Employment Services
Regional centers contract with employment services programs and
providers to address the employment needs of individuals with
developmental disabilities. Consumers are placed in jobs
according to their individual skills, needs and choices, and
they are provided support services on an individual or group
basis. In addition to meeting the employment needs of the
consumer, work programs can also greatly increase opportunities
for community integration for consumers.
Work Activity Programs (WAPs) are employment services programs
in a sheltered work environment for consumers who have acquired
basic vocational and independent living skills. All WAP work is
paid at a daily per capita rate based on productivity.
Alternatively, Supported Employment Programs (SEPs) are
community-based rehabilitation programs that focus on helping
consumers obtain, retain or maintain employment in integrated
settings. SEPs often involve job coaches that provide
on-the-job services and training, and wages paid directly to the
consumer by the employer. If it is determined that some form of
supported employment would best meet the employment needs of a
consumer, a regional center will refer the consumer to the
Department of Rehabilitation (DOR), which is responsible for
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increasing employment opportunities in the community and
providing time-limited employment services to individuals with
disabilities. If a regional center consumer needs long-term
support to continue in their place of employment, the
responsibility for providing a job coach and maintaining
supportive services shifts back to DDS.
DOR provides and pays for three tiers of employment-related
services, with set corresponding rates, for individuals with
developmental disabilities. These include:
1) Intake to determine employment needs and develop a plan
of action;
2) Placement in a particular job; and
3) Retention for 90-days in a particular job.
COMMENTS :
According to the author, this bill seeks to increase the
statutorily-set supported employment rates and one-time intake,
placement and maintenance fees to the levels achieved in 2006,
which were maintained until a 10% cut was applied in the 2008-09
Budget Act. While all of the rates and fees included in W&I
Code �4860 have applied to regional centers in the past, the
only rates that apply to services currently paid for by the
regional centers are the individual- and group-based hourly job
coaching rates for supported employment (which the author seeks
to increase from $30.82 to $34.24). Conversely, the fees
established in this section, which the bill also increases, are
intended to be paid by the regional centers to program providers
only when W&I Code �4855 applies, or in other words, when a
consumer is referred to DOR by the regional center and is placed
on a waiting list. In this instance, the regional center would
be responsible for paying the indicated fees while the consumer
awaits services from DOR. However, while there may be a waiting
list within the DOR service and rate structure for people with
developmental disabilities again in the future, consumers who
are referred now are given equal consideration among individuals
that do not have developmental disabilities and are not placed
on waiting lists.
While the elimination of the DOR waitlist for individuals with
developmental disabilities would seem to eliminate the need for
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the fee increases in the bill, the increases sought will
actually result in fee increases for providers of services
through DOR, as DOR bases its uniform service structure for
individuals with developmental disabilities -including
applicable rates and fees-on WIC �4860. Essentially, the rate
and fee increases included in this bill will apply to consumers
regardless of whether the services outlined in this Section are
paid for by the regional centers or through DOR.
In support, the Association of Regional Center Agencies states:
"This proposed rate increase will restore rates to 2006
levels, and will help bolster the offerings of agencies in
supporting persons with developmental disabilities toward
the objective of finding and keeping a job. This
population already has an unemployment rate of over 80% in
California. As the state's economy recovers, this bill
will help ensure that people with developmental
disabilities do not get left behind."
RELATED LEGISLATION
AB 1041 (Chesbro) establishes Employment First Policy
requirements related to the inclusion of integrated employment
opportunities and services in a regional center consumer's
individual program plan (IPP).
AB 1112 (Ammiano) would remove the statutorily indicated rates
and fees that apply to job coaching and supported employment
services, and would replace them with a cross-reference to rates
set by the Department of Rehabilitation. *It should be noted
that the provisions of AB 954 (Maienschein) and AB 1112
(Ammiano) are in direct conflict, as currently drafted.
SB 577 (Pavley) requires DDS to establish a pilot program for
young adults with ASD to help them find pathways to financial
independence through work.
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REGISTERED SUPPORT / OPPOSITION :
Support
Association of Regional Center Agencies (ARCA)
The Alliance
Opposition
None on file
Analysis Prepared by : Myesha Jackson / HUM. S. / (916)
319-2089